多学科团队协作模式在微创肾部分切除患者中的应用效果  

Application effect of multidisciplinary teamwork model in patients with minimally invasive partial nephrectomy

作　　者：王卫红[1] 邹莉 王巧萍 陆琴琴 周慧平 谢浩芬[2] 严泽军[1] Wang Weihong;Zou Li;Wang Qiaoping;Lu Qinqin;Zhou Huiping;Xie Haofen;Yan Zejun(Department of Urology,Ningbo First Hospital,Zhejiang Province,Ningbo 315010,China;Department of Nursing,Ningbo First Hospital,Zhejiang Province,Ningbo 315010,China)

机构地区：[1]浙江省宁波市第一医院泌尿外科,315010 [2]浙江省宁波市第一医院护理部,315010

出　　处：《中华现代护理杂志》2021年第30期4119-4123,共5页Chinese Journal of Modern Nursing

基　　金：中华医学会杂志社2019年护理学科研究课题(CMAPH-NRI2019049)。

摘　　要：目的探讨多学科团队协作模式在腹腔镜肾癌肾部分切除患者中的应用效果。方法采用便利抽样的方法选取浙江省宁波市第一医院2019年2—12月收治的肾癌并行腹腔镜下肾部分切除术的患者86例,按入院时间分为对照组和观察组,每组各43例。对照组实施泌尿外科护理常规和加速康复外科指南推荐的各项措施,观察组在对照组基础上采用基于循证护理的多学科团队协作模式。术后1、3、5 d使用Kolcaba舒适状况量表、数字疼痛评分法测评两组患者的舒适度和腰背部疼痛情况,术后5 d使用汉密尔顿焦虑量表测评两组患者的焦虑情况,收集两组术后康复指标(术后平卧位时间、绝对卧床时间、肛门排气时间、引流管留置时间、术后住院日)。结果观察组患者术后1、3、5 d的舒适状况量表总评分高于对照组,腰背部疼痛评分低于对照组;观察组患者术后焦虑评分、术后平卧位时间、绝对卧床时间、肛门排气时间、引流管留置时间、术后住院日均低于对照组;两组比较差异均有统计学意义(P<0.05)。两组患者均未发生术后出血和下肢DVT。结论多学科团队协作模式可以缓解微创肾部分切除患者的术后焦虑状态,提高其整体舒适度,缩短术后住院日,促进患者术后康复。Objective To explore the application effect of multidisciplinary teamwork mode in patients with laparoscopic partial nephrectomy of renal carcinoma.Methods A total of 86 patients with renal cancer who received laparoscopic partial nephrectomy in Ningbo First Hospital of Zhejiang Province from February to December 2019 were selected by the convenient sampling method.According to admission time,the patients were divided into the control group and the observation group,with 43 cases in each group.The control group implemented urological nursing routines and various measures recommended in the accelerated rehabilitation surgery guidelines,while the observation group adopted a multidisciplinary team collaboration model based on evidence-based nursing on the basis of the control group.The Kolcaba General Comfort Questionnaire(GCQ)and Numerical Pain Rating Scale(NPRS)were used to evaluate the comfort and low back pain of the two groups at 1,3,and 5 days after surgery.Hamilton Anxiety Scale was used to evaluate anxiety of patients in both groups 5 days after surgery,and postoperative rehabilitation indicators(postoperative supine position time,absolute bed time,anal exhaust time,drainage tube indwelling time,postoperative hospital stay)were collected in both groups.Results The total score of GCQ of observation group was higher than that of control group on 1,3,and 5 days after operation, and lower back pain score was lower than that of control group. The postoperative anxietyscore, postoperative supine position time, absolute bed time, anal exhaust time, drainage tube indwellingtime and postoperative hospitalization days in the observation group were lower than those in the control group.There were statistically significant differences between the two groups (P < 0.05). There was no postoperativebleeding or deep venous thrombosis (DVT) in the lower limbs of patients of the two groups. Conclusions Themultidisciplinary teamwork model can alleviate the postoperative anxiety of patients with partial nephrectomy,improve their

关 键 词：围手术期护理 肾部分切除术 多学科团队协作 加速康复 

分 类 号：R473.73[医药卫生—护理学]